External fixation is a type of osseous fixation commonly used to treat bone trauma cases and other orthopedic conditions. This form of reduction requires drilling holes into unaffected regions of bone around the fracture and screwing bolts or wires into the holes. External fixation is a minimally invasive procedure that is performed by placing a scaffolding frame with associated wires, pins or both on the outside of the damaged extremity. Small pins and wires are then used to hold the bone in its intended position.

Installation of external fixators requires general anesthesia and is usually performed in an operating room. Because the pins pierce through the skin, constant cleaning of the wound is necessary. Removal of the external device can be performed during an office visit without anesthesia.

While the value of the internal fixation market greatly exceeds that of the external fixation market, external fixation has been gaining popularity with certain surgeon groups for specific indications since its introduction. This is due to surgeon preference for closed or minimally invasive treatment methods when possible. There are circumstances for which external fixation is clearly preferable, including open fractures with significant soft tissue damage, multiple trauma sites that require immediate fixation, and in patients where there is insufficient bone stock or when infection precludes the possibility of internal fixation.

Prior to the growth in popularity of external fixation among orthopedic surgeons, internal fixation devices and casts were commonly used to treat fractures, depending on the severity and complexity of the case. The use of casts on complex fractures has been implicated in causing fibrosis (fibrous tissue death) and immobilization of joints and muscles near the fracture. The use of external fixators reduces the likelihood and severity of fibrosis as well as of joint and muscle immobilization.As opposed to internal fixation, external fixation involves the stabilization of fractures by rods and pins that attach from outside the body. The rods and pins are anchored to rigid frames. Unilateral fixators are located externally on only one side of the limb. Circular fixators are ring-shaped and surround the fractured limb. While circular fixators are more cumbersome, they offer more versatility and are stronger and more stable when weight is applied.